RESUMO
Mucinous cystadenofibroma of ovary is a rare benign tumor. A 55-year old post-hysterectomy woman with ovarian mucinous cystadenofibroma, diagnosed as benign cystic lesion prior to surgery. Patient successfully underwent excision of cyst.
RESUMO
Resumen El embarazo ectópico en pacientes histerectomizadas es un evento poco común y rara vez se considera en el diagnóstico diferencial en mujeres con esa condición. Se comunica el caso de una paciente de 30 años con antecedentes de histerectomía realizada hacía 6 años, que se presentó en el servicio de urgencias con evolución de tres días de dolor abdominal bajo. La ecografía mostró un saco gestacional con embrión y presencia de líquido libre en el fondo de saco Douglas. El examen histológico de la muestra operatoria reveló vellosidades coriónicas y un embrión dentro de la trompa uterina.
Abstract Ectopic pregnancy in hysterectomized patients is an uncommon event and it is rarely considered in the differential diagnosis. We present the case of a 30-year-old patient with hysterectomy performed 6 years before who presented to the emergency service with a 3-day evolution of lower abdominal pain. Ultrasonography showed a gestational sac with embryo and the presence of free fluid in the Douglas sac. Histological examination of the surgical piece revealed chorionic villi and an embryo within the uterine tube.
RESUMO
Fallopian tube prolapse into the vaginal vault is a very complication of hysterectomy where the adnexa is preserved. The overall occurrence after all routes of hysterectomy is 0.01-0.05%. Several factors have been suggested to contribute to the condition such as vault hematoma, improper closure of vault, early resumption of sexual activity. Due to the misdiagnosis, there is often delay in the diagnosis and its management. The only means of definitive diagnosis is histopathology. A 30-year-old P2l2 presented to us after 3 years of post-hysterectomy with abdominal pain and bleeding pv on and off. On examination prolapsed fallopian tube was found in the vaginal vault on speculum. Biopsy was done in the outside hospital and was confirmed to be the tube. Patient underwent combined laparoscopic and vaginal method. Vaginal excision of the tube was done. Prevention by prophylactic salpingectomy and by suturing the adnexa high up in the pelvis in abdominal hysterectomy.
RESUMO
El objetivo de este estudio fue comparar los resultados de la culdoplastía de Mayo con la colposacropexia abdominal en la corrección del prolapso de la cúpula vaginal poshisterectomía. Se revisaron las historias clínicas de 155 pacientes con prolapso de cúpula vaginal poshisterectomía en las que se procedió a la corrección quirúrgica entre febrero 2013 y noviembre 2017. Se realizó seguimiento para evaluar la satisfacción del paciente y el resultado a largo plazo. La edad promedio de las pacientes al momento de la cirugía fue de 67,1 +/- 5,6 años y 69,0 % de las pacientes tenían antecedentes de haber sido sometidas a histerectomía abdominal. El tiempo medio entre la histerectomía y la cirugía de corrección fue de 16,9 +/- 3,6 años. Ciento diecinueve pacientes se sometieron a abordaje vaginal utilizando la técnica de culdoplastía de Mayo (grupo A) y 36 pacientes se sometieron a colposacropexia abdominal (grupo B). Durante la cirugía se produjeron tres casos (2,5 %) de lesión vesical inadvertida en el grupo A. En el grupo A se observaron 2 casos de recurrencia comparado con un solo caso en las pacientes del grupo B (p = ns). Al analizar la satisfacción de la cirugía, 84,9 % de las pacientes del grupo A y 77,7 % de las pacientes del grupo B se declararon satisfechas con los resultados quirúrgicos. Se concluye que la corrección del prolapso de la cúpula vaginal mediante colposacropexia abdominal y culdoplastía de Mayo son procedimientos seguros y efectivos.
The aim of this study was to compare the results of the Mayo culdoplasty with abdominal colposacropexy in the correction of post-hysterectomy vaginal vault prolapse. Medical records of 155 patients with post-hysterectomy vaginal vault prolapse were reviewed in which the surgical correction was carried out between February 2013 and November 2017. Follow-up was performed to evaluate the patient's satisfaction and the long-term result. The average age of the patients at the time of surgery was 67.1 +/- 5.6 years and 69.0% of the patients had a history of having undergone an abdominal hysterectomy. The mean time between hysterectomy and correction surgery was 16.9 +/- 3.6 years. One hundred and nineteen patients underwent vaginal access using the Mayo culdoplasty technique (group A) and 36 patients underwent abdominal colposacropexy (group B). During surgery there were three cases (2,5 %) of inadvertent bladder injury in group A. In group A, 2 cases of recurrence were observed compared with a single case in patients in group B (p = ns). When analyzing the satisfaction of the surgery, 84,9 % of the patients of group A and 77,7 % of the patients of group B declared themselves satisfied with the surgical results. It is concluded that the correction of vaginal vault prolapse by abdominal colposacropexy and Mayo culdoplasty are safe and effective procedures.
Assuntos
Humanos , Feminino , Cirurgia Geral , Prolapso Uterino , Histerectomia Vaginal , Micção , Venezuela , Satisfação do PacienteRESUMO
Intravenous leiomyomatosis (IVL) is extremely rare with just around 300 cases reported in literature. 1 With its unusual growth pattern and clinically aggressive behavior, this benign tumor can masquerade as a malignancy and present a diagnostic challenge. Concurrent uterine fibroids or recent hysterectomy for the same often provides a hint towards the diagnosis. 2 The median interval between hysterectomy and diagnosis of IVL is approximately 4 years. 3 We present a case of IVL detected 10-years post total hysterectomy, bilateral salpingo-oophorectomy (THBSO) and parametriectomy with emphasis on multimodality imaging with multip